Adeyoju Daniel A O, Josan Amandeep S, Taylor Laura J, MacLaren Robert E
Oxford Eye Hospital, Oxford University Hospitals NHS Trust, Oxford, UK.
Nuffield Laboratory of Ophthalmology, Department of Clinical Neurosciences, University of Oxford, NIHR Oxford Biomedical Research Centre, Oxford, UK.
Transl Vis Sci Technol. 2025 Jun 2;14(6):18. doi: 10.1167/tvst.14.6.18.
Scotopic microperimetry measures retinal sensitivity under very low light and may be useful in conditions characterized by nyctalopia, such as retinitis pigmentosa and age-related macular degeneration. The Scotopic Macular Integrity Assessment device enables two-color perimetry to isolate rod and cone responses. This study assesses the reliability, test-retest repeatability, and sensitivity in healthy participants aiming to establish normative values.
Scotopic microperimetry was performed using cyan and red stimuli on a 37-point radial grid after dark adaptation on control participants with no history of eye disease and visual acuity of 0.1 logarithm of the minimum angle of resolution or better. Fixation stability, fixation losses, and identification of the rod-free zone were used as reliability metrics. A subset underwent repeat testing within 4 weeks.
Thirty-nine participants (19 male and 20 female), median age 24 years (interquartile range, 9.5 years) and 23 years (interquartile range, 9 years) for the right and left eyes, respectively, completed testing. Overall 77 eyes underwent scotopic testing, with 82% meeting reliability criteria. Mean cyan and red sensitivities were 19.9 ± 1.1 dB and 20.9 ± 1.2 dB in right eyes, and 20.1 ± 1.4 dB and 21.3 ± 1.4 dB in left eyes, respectively. Volumetric cyan and red sensitivities were 2868 ± 157 dB.deg2 and 3077 ± 176 dB.deg2 in the right eyes, respectively, and 2892 ± 205 dB.deg2 and 3126 ± 207 dB.deg2 in the left eyes, respectively. Mean sensitivity coefficients of repeatability (CoR) were ± 1.4 dB (cyan) and ± 2.1 dB (red) while pointwise coefficients of repeatability were ± 7.2 dB (95% confidence interval, 6.5-7.6 dB) for cyan and ± 7.9 dB (95% confidence interval, 7.3-8.4 dB) for red, with no significant differences between eyes or genders. Fixation stability assessed using the 95% bivariate contour ellipse area for cyan was 2.9 ± 5.9 deg2 and 2.3 ± 2.2 deg2 for the right and left eyes, respectively, and for red were 0.7 ± 0.6 deg2 and 0.9 ± 0.8 deg2 for the right and left eyes, respectively. Again, there were no significant differences between cyan and red tests (Friedman test, bivariate contour ellipse area 63%, P = 0.455; bivariate contour ellipse area 95%, P = 0.432).
Scotopic microperimetry using the Scotopic Macular Integrity Assessment device was feasible and well-tolerated. Repeatability metrics demonstrated limitations in fine spatial mapping of scotopic retinal sensitivity.
This study highlights potential areas for future improvements in scotopic microperimetry before its use as an outcome measure in clinical trials for retinal disease.
暗视微视野检查可测量在非常低的光照条件下的视网膜敏感度，对于以夜盲为特征的疾病，如视网膜色素变性和年龄相关性黄斑变性可能有用。暗视黄斑完整性评估设备可进行双色视野检查以分离视杆和视锥反应。本研究评估健康参与者中的可靠性、重测重复性和敏感度，旨在建立正常参考值。
对无眼部疾病史且视力为1.0最小分辨角对数或更好的对照参与者进行暗适应后，使用青色和红色刺激在37点放射状网格上进行暗视微视野检查。注视稳定性、注视丢失和无杆区的识别被用作可靠性指标。一部分参与者在4周内进行重复测试。
39名参与者（19名男性和20名女性）完成了测试，右眼和左眼的年龄中位数分别为24岁（四分位间距，9.5岁）和23岁（四分位间距，9岁）。总共77只眼接受了暗视测试，其中82%符合可靠性标准。右眼青色和红色敏感度的平均值分别为19.9±1.1dB和20.9±1.2dB，左眼分别为20.1±1.4dB和21.3±1.4dB。右眼青色和红色敏感度的容积值分别为2868±157dB·deg²和3077±176dB·deg²，左眼分别为2892±205dB·deg²和3126±207dB·deg²。重复性的平均敏感度系数（CoR）为±1.4dB（青色）和±2.1dB（红色），而青色和红色的逐点重复性系数分别为±7.2dB（95%置信区间，6.5 - 7.6dB）和±7.9dB（95%置信区间，7.3 - 8.4dB），双眼或性别之间无显著差异。使用95%双变量轮廓椭圆面积评估的注视稳定性，右眼青色为2.9±5.9deg²，左眼为2.3±2.2deg²，右眼红色为0.7±0.6deg²，左眼为0.9±0.8deg²。同样，青色和红色测试之间无显著差异（Friedman检验，双变量轮廓椭圆面积63%，P = 0.455；双变量轮廓椭圆面积95%，P = 0.432）。
使用暗视黄斑完整性评估设备进行暗视微视野检查是可行的且耐受性良好。重复性指标显示在暗视视网膜敏感度的精细空间映射方面存在局限性。
本研究突出了在暗视微视野检查作为视网膜疾病临床试验的结局指标使用之前，未来改进的潜在领域。
